Portraits of Care
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Worries About Overburdening the Healthcare System
“The system feels tired, and I hesitate to add to its weight unless I really need to.”
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This persona story was developed to reflect the experiences shared by patients who generally feel OK day-to-day, have a long-standing relationship with a primary care provider, and use the healthcare system less frequently — often because they've learned to wait, self-monitor, and manage concerns on their own.
Pat's experience brings forward insights from patient interviews about communication, access, and decision-making in primary care, especially among people who are mindful of system demands and take a measured approach to seeking care.
Many health system conversations focus on patients with complex needs or frequent care use. These experiences are vital to understand — and so is Pat's.
Pat's story represents a different, often less visible reality: the patient who trusts the system, respects clinicians, and worries about taking up too much time. He is not disengaged. Through experience and a strong sense of responsibility, he makes careful judgments about when to access care in a health system that is perceived to be under strain.
This persona supports reflection on:
Pat's experience reveals quiet tensions that shape whether concerns are voiced early, preventative care is pursued, and patients feel permission to come in. As you read or listen, notice:
Several patients who were interviewed that inform Pat's experience, described a growing sense that the health system is overburdened — and a belief they should only seek care when necessary. While this can sound like virtue ("I don't want to take up space"), it can lead to delays, symptom minimization, or avoided follow-up. Pat's story invites a shared question, not only for patients, but for care teams as well: What happens when people who do trust the health system no longer feel like it is acceptable to use it?
I've been with the same family doctor for about 20 years. I don't go very often, but the care is fine when I do go. I feel privileged to have anyone available for me. So much so that even if I moved from one end of the city to another, I probably wouldn't change clinics. Although I suspect I might be going even less than I do now.
Fortunately, I'm feeling fairly healthy now. I usually only go when things seems off. And even then, I'll wait another week to see if it'll pass. I never want to stress the system. It already seems so stressed. Sure, I would like to use my provider for preventative checks. There was a time you could get routine lab work done, but that doesn't seem to be the case any more.
I can get appointments, but it's on me to plan around the system. I've learned the strategies — call or email early, expect some waiting, and being patient. There's a fair bit of consideration involved in deciding when something is serious enough to book. Once I'm in the room, the care feels focused and professional. I trust my doctor, though sometimes it feels like my past follows me in, even though I've made changes. I was raised to trust professionals, and I still do, but I'm learning to ask more questions. The system feels tired, and I hesitate to add to its weight unless I really need to. Still, when I do go, it helps that my care team knows me well enough to keep things moving.
Listen to Pat describe how they feel about their care.
I try to come prepared out of respect for the doctor's time and the system itself. I think things through, make a short list, maybe do a bit of reading. I used to accept whatever was recommended and walk out the door. If they said jump on one foot, I probably would have. I still trust their expertise, but I will ask a few questions to understand, not to challenge. If something isn't working, it's my responsibility to say so.
Listen to Pat describe how they prepare for appointments.
Audio placeholder — a recorded narration of Pat’s story for accessibility and engagement purposes.
Listen to Pat describe what they need from their healthcare team.
Listen to Pat describe what they want from the health system.
These questions are intended to encourage individual reflection on Pat’s experience and identify opportunities to improve the quality of care for people with similar experiences.
The quality dimensions provide a common language for understanding quality as it should be experienced by people.
The questions that follow invite you to consider Pat’s story through the interconnected dimensions of People-centred, Efficient and sustainable, and Accessible and timely, while recognizing that other dimensions may also be relevant.
The wholistic preferences, needs, and strengths of people and communities matter.
Pat values the trusting relationship they have built with their family physician and appreciates opportunities to ask questions, discuss changes in their health, and participate in decisions about their care. While Pat’s past health history is part of their story, they hope to be seen as the person they are today.
What aspects of Pat’s lived experience, priorities, and changing circumstances must be understood to support care that reflects what matters most to Pat?
Resource use balances individual, population, systemic, social, and environmental factors to benefit current and future generations.
Pat understands that healthcare resources are limited and wants to use them responsibly. They are curious about how the health system works, wonder how resources can be used wisely, and see opportunities to create more space for prevention while making better use of approaches such as virtual care.
How can healthcare teams and systems support responsible use of healthcare resources without discouraging people from seeking care when they need it?
People can readily access services that meet their needs.
Pat has a trusted family physician and generally feels confident in the care they receive. Yet before booking an appointment, they carefully consider whether their concern is serious enough and whether they should wait longer or manage it themself. Pat’s desire to avoid burdening the system sometimes leads them to delay seeking care.
What messages — spoken or unspoken — might influence when patients like Pat decide it is appropriate to seek care?
Are there other quality dimensions that are also relevant to Pat’s experience?
The Alberta Quality Dimensions for Health are one part of the Framework for an Integrated People-centred Health System. The Framework also includes enablers, which create the conditions that support quality care, and shared responsibilities, which describe how we show up with and for one another.
Explore the Framework to learn how the dimensions, enablers, and shared responsibilities work together to support an integrated people-centred health system.
These questions invite you to consider how the insights gained through reflection and exploration could inform improvements within your own practice, team, organization, community, or the broader health system.
These resources build on the reflections and insights gained through this persona and support team discussion, quality improvement, and a deeper understanding of this topic.
Facilitate team learning: Continue the conversation with your team using the Persona Facilitation Guide: Open the Pat chapter (future link page/pdf), which includes facilitation tips, discussion activities, and planning tools.
Support improvement: Learn how you can support providers using the personas for quality improvement with the Physician Practice Improvement Program (PPIP) Fact Sheet: Personas (future link). Also, check out the following Health Quality Alberta resources:
Expand your knowledge: Explore additional clinical, community, and educational resources related to the topics explored through this persona.
These questions are intended to encourage reflection on Pat’s experience and help make connections with your own experiences or those of someone you care about.
These resources build on the reflections and insights gained through this persona and provide additional information and resources related to this topic.
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